A mastoidectomy is a surgical procedure that removes diseased mastoid air cells. These cells sit behind your ear in a hollow space in your skull. The diseased cells are often the result of an ear infection that has spread into your skull.
The infection sometimes spreads to the temporal bone. Your doctor may need to remove parts of the infected bone if this occurs. This results in hearing loss.
There are several types of mastoidectomy, including:
- simple mastoidectomy, in which your surgeon opens your mastoid bone, removes the infected air cells, and drains your middle ear
- radical mastoidectomy, in which your surgeon may remove your eardrum, remove your middle ear structures, and possibly place a skin graft in your middle ear
- modified radical mastoidectomy, which is a less severe form of radical mastoidectomy that involves removing some, but not all, middle ear bones and rebuilding your eardrum
You can expect some hearing loss from a radical and modified radical mastoidectomy.
This surgery isn’t as common as it used to be. Antibiotics usually treat infections, but surgery is an option if antibiotics fail.
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A mastoidectomy can treat complications of chronic otitis media (COM). COM is an ongoing ear infection in your middle ear. It can cause a cholesteatoma, which is a skin cyst or pouch, if it’s left untreated. The cyst grows gradually over time and may lead to serious complications such as:
- abscess in the brain
- dizziness or vertigo
- damage to your facial nerve that causes facial paralysis
- meningitis, or inflammation of the membranes of your brain
- labyrinthitis, or inflammation of your inner ear
- ongoing ear drainage
- the spread of the cyst into your brain
Your doctor may also perform a mastoidectomy to put in a cochlear implant. This small, complex electronic device can help provide you with a sense of sound if you’re profoundly deaf or severely hard of hearing.
This surgery can also remove abnormal growths at the base of your skull.
A mastoidectomy is usually performed using general anesthesia. This ensures that you’re asleep and unable to feel pain. For a simple mastoidectomy, your surgeon will usually:
- access your mastoid bone through your ear or a cut made behind your ear
- use a microscope and a small drill to open your mastoid bone
- use suction irrigation to keep the surgical area free of bone dust
- remove the infected air cells
- stitch up the operative site
- cover the site with gauze to soak up the drainage
Your surgeon may also use a facial nerve monitor. This ensures the facial nerve isn’t damaged.
You can can expect to have bandages over your ear when you wake up. There will also be stitches close to your ear. You may have a headache, discomfort, and some numbness.
After surgery, your doctor may:
- prescribe pain medication
- give you topical antibiotic drops to decrease your risk of infection
- ask you to schedule a return for removal of your bandages and stitches
Your doctor may also tell you to cover the site when you bathe, using a cup or a cotton ball covered in petroleum jelly. You should avoid strenuous activity and air travel. Refrain from putting pressure on your ear as well.
Complications of a mastoidectomy can include:
- facial nerve paralysis or weakness, which is a rare complication caused by facial nerve injury
- sensorineural hearing loss, which is a type of inner ear hearing loss
- vertigo, which may persist for several days
- a change in taste that causes food to seem metallic, sour, or otherwise off and often resolves after a few months
- tinnitus, which causes abnormal noises in your ear such as ringing, popping, and hissing
Call your doctor if you experience any of these symptoms. You should also call your doctor if you have heavy ear bleeding, a fever over 100.5°F, or if your bandage comes off.
The outlook varies depending on the reason for the mastoidectomy and the type of mastoidectomy. Hearing loss is common with both modified radical and radical mastoidectomy.
You need to have regular follow-ups with your doctor if you have cholesteatoma. Your doctor will check to make sure that your ear is healing correctly and will remove your bandage during your follow-up appointment.